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Scientific advances have changed what is possible for many people living with cancer. Yet, for cancers that remain difficult to treat, too many people still face limited options, underscoring the need for new approaches that connect innovation with meaningful patient need.

As the oncology community gathers for the European Society for Medical Oncology (ESMO) Congress, Moitreyee Chatterjee-Kishore, Head of Oncology Development, and Emad Siddiqui, Head of Medical Affairs Global Brand Strategy, share insights into Astellas' unique approach to oncology care. Their conversation focuses on how the company connects scientific innovation with real-world evidence and clinical experience to pursue new approaches in areas where significant needs remain.

What defines and differentiates Astellas' approach to cancer?

Moitreyee Chatterjee-Kishore: We pursue science with the potential to transform what is possible for patients with limited or no therapeutic options. Our purpose is to serve people throughout their cancer experience by advancing approaches that could help diagnose and treat disease earlier, provide new options if it returns and improve quality and duration of life. Our aim is not simply incremental progress, but advances that could open new treatment possibilities in areas of significant unmet need.

That starts with a deep understanding of what drives some of the most difficult-to-treat cancers and what a potential treatment would need to overcome. We then pair that insight with the modality best suited to addressing the challenge. This is the core strategy behind our Focus Area Approach: connecting deep disease biology with innovative treatment modalities, then applying that combination in disease areas with high unmet need.

Emad Siddiqui: In parallel, we also consider the path from research to care. Do we understand the patient journey? Where is the greatest unmet need? Which type of patient may benefit the most? What testing and evidence will healthcare professionals need to make informed treatment decisions?  Asking those questions early helps keep the science connected to how an advance might ultimately be used in clinical practice and benefit patients.

"Our aim is not simply incremental progress, but advances that could open new treatment possibilities in areas of significant unmet need."

Moitreyee Chatterjee-Kishore

Astellas has approved treatments in bladder, prostate and gastric cancers. What can clinical practice reveal that research alone cannot?

Emad Siddiqui: Pivotal clinical research can establish treatment's benefits and risks under defined study conditions. Real world evidence reveals what happens around the treatment in real-world situations, including the precision brought in with testing in routine cancer care, how the results shape decisions, what support patients, caregivers and physicians may need and how their priorities can change over time.

Those insights can point to opportunities to intervene earlier, preserve function and maintain quality of life. They can also reveal barriers, from testing delays to ease-of-access and the need for clearer education or support. These observations do not replace evidence. They show where more evidence is needed and help future research reflect the realities of care.

Moitreyee Chatterjee-Kishore: Real-world experience also helps us refine existing approaches, explore new ones and build practical questions into development earlier.

In bladder cancer, experience with antibody-drug conjugates, or ADCs, has shown us how selecting the right target, delivering treatment effectively and balancing benefit with safety, all influence outcomes. Those lessons are now informing how we design and evaluate ADCs in other indications, including gastric and pancreatic cancers. Likewise, our experience in prostate cancer is helping us identify where additional approaches are needed for people with more advanced disease and is informing our exploration of innovative approaches such as T-cell engagers.

Targets such as CLDN18.2 and KRAS are drawing growing attention across oncology. What is distinctive about how Astellas is approaching them?

Moitreyee Chatterjee-Kishore: What is distinctive is the depth of our experience and the range of approaches we are exploring for each target. Astellas was among the first companies to recognize the potential of targeting CLDN18.2 nearly a decade ago. Because this protein is found on the surface of some cancer cells, it can be approached in different ways. Beyond monoclonal antibodies, we are exploring both ADCs and T-cell engagers, each designed to act on the same target in a different way.

KRAS presents a different challenge because it is a cancer-driving protein inside the cell and has historically been difficult to address. We are exploring targeted protein degradation (TPD), which takes a fundamentally different approach from traditional inhibitors. Rather than blocking a protein's activity, TPD is designed to use the cell's own disposal system to remove the disease-driving protein. This opens a different way of thinking about targets that have historically been difficult to develop therapeutics against. The common thread is an openness to different approaches based on the biology and location of each target.

Identifying a target is only part of the challenge. What does it take for biomarker-guided treatment to work in practice?

Emad Siddiqui: Understanding the target is just the beginning. Scientific progress matters most when it can work in the realities of care. A biomarker changes care only when the full pathway works; healthcare professionals knowing who to test and when to test them, results being available in time, and the evidence is clear enough to guide treatment decisions. Access to testing, turnaround time and workflow can all affect whether the right patients are able to access the therapies designed for their disease.

Our experience with CLDN18.2 shows why these practical steps need to be considered alongside the science. Clinical evidence, reliable testing and confidence in patient identification all help translate a biological insight into a treatment decision. Listening to clinicians helps us identify barriers and shape the evidence, medical education and support needed in practice.

"Scientific progress matters most when it can work in the realities of care."

Emad Siddiqui

Looking ahead, what makes you hopeful about the future of cancer care?

Emad Siddiqui: What gives me hope is our growing ability to connect scientific discovery in a more targeted manner, with the potential of improving treatment outcomes for our patients. Promising ideas are increasingly supported by more precise testing, evidence healthcare professionals can use and a better understanding of what treatment may mean for the person receiving it. Listening to healthcare professionals, patients and caregivers helps us see which questions still need answers. The goal is progress that can become meaningful in people's lives.

Moitreyee Chatterjee-Kishore: I am hopeful because this deeper understanding is giving us more precise ways to take on cancers that have long been difficult to treat. By combining the science with what we learn in clinical practice, we can make bolder, better-informed choices and advance innovative treatment approaches. This gives us the potential to change the course of cancer and enhance quality of life for patients in need.